284 APPLIED PHYSIOLOGY 



but this is hardly likely to be the sole reason for its 

 occurrence. If the bile escapes by a fistula the reabsorp- 

 tion of bile salts is, of course, arrested ; hence fistula 

 bile is always poorer in that ingredient than natural 

 bile, and the results of analysis of the former cannot 

 be taken as representing the true composition of the 

 natural secretion. 



The bile salts have a distinctly toxic action in the 

 body, causing destruction of red blood corpuscles, a 

 slowing of the heart by direct action upon its muscle 

 and the cardiac ganglia, and a paralyzing action on the 

 higher cerebral centres, which results in coma and death. 

 To these effects some of the clinical symptoms of jaundice 

 have been attributed. 



The cholesterin of the bile is now generally admitted 

 to be derived from the cells lining the biliary passages 

 and gall-bladder. In catarrh of these the amount of 

 cholesterin produced may be increased beyond the power 

 of the bile salts to keep it in solution, and the formation 

 of cholesterin gall-stones is favoured. Attempts have 

 been made, but without much success, to dissolve such 

 stones by administering bile salts by the mouth. 



It used to be believed that the cholesterin of bile was 

 a waste product derived from the nervous system, and 

 one theory of cholaemia was based upon the assumption 

 that the symptoms of that condition were due to an 

 insufficient removal of waste products from the brain 

 and nervous system. Since the true source of choles- 

 terin has been discovered, however, this theory has been 

 abandoned. 



The chief mineral constituent of the bile is calcium, 



